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Wilshire Early Childhood Learning Center

Summer Registration 2020

THIS FORM IS CURRENTLY FOR VIEWING ONLY

REGISTRATION FEE: Payble today Tuesday, March 3rd. Please drop off your check in the ECLC office.

Write child’s first & last name in memo section of check.

$200 PER CHILD (NON-REFUNDABLE - $100 credited towards tuition)

One check per family if registering multiple children - $200 PER CHILD.

** Infants must have turned 3 months old by August 31, 2019**

** Children currently enrolled in Pre-K 4 may attend **

{childsFirst} {childsLast} is unable to attend ECLC Summer School. Children must be 3 months on or before August 31st 2019

Child's First Name*

Child's Last Name*

Birth Date*

Month Day Year

Gender*

Parents' Name(s):*

Phone Number*

Area Code Phone Number

Email*

Are you a member of Wilshire Baptist Church?*

Mark your first and second choices below - if you are not flexible please make the same choice for both options.
ECLC will notify you by email of classroom assignment for summer session 2020

Days 1st Choice*

Days 2nd Choice*

Additional Comments